Provider Demographics
NPI:1225468200
Name:THE ABIGAIL GROUP
Entity Type:Organization
Organization Name:THE ABIGAIL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ESTELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-254-8881
Mailing Address - Street 1:2626 N DUNDEE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7538
Mailing Address - Country:US
Mailing Address - Phone:813-258-2919
Mailing Address - Fax:813-254-2544
Practice Address - Street 1:320 S DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2106
Practice Address - Country:US
Practice Address - Phone:813-258-2919
Practice Address - Fax:813-254-2544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLALE0498310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE0498OtherASSISTED LIVING RESIDENCE